Early diagnosis, risk stratification and monitoring the response to treatment in patients with heart failure is an unmet clinical need. Heart failure has a 50% mortality rate within 5 years of diagnosis and currently 25% of heart failure patients below 65 years of age are re-hospitalised within 30 days of being discharged. Adequate accessibility to decentralised testing methods such as the use of point-of-care diagnostics are key to accurately identifying and stratifying heart failure patients’ risks after being discharged and avoiding regular and repeated hospitalisations.
To address this current unmet need, we aim to identify and measure salivary-based biomarkers, which are known to be direct causative agents in the development of heart failure, using an engineered enzymatic based point-of-care biosensor. Our research aims to optimise the selection and specificity of the recognition elements to the target analyte using high-throughput directed protein evolution processes such as mRNA display and phage display to select recognition elements with the most desirable functions for recognition of heart failure salivary biomarkers. We will address the key issues of biosensor integration into cost-effective, easy-to-use, portable devices, which are functional in the most remote settings by untrained patients. These biosensors will provide heart failure patients with reliable and easily obtainable information regarding their disease status without the need for reliance on healthcare workers and facilities. This will reshape and refine contemporary heart failure risk stratification models, as opening a new era in precision cardiology.
Ultimately, the process of engineering these protein-based biosensors into point-of-care, saliva-based diagnostic platforms for the detection and triaging of heart failure patients will be undertaken. The main bottleneck of the current diagnostic biosensor platform remains the applicability of these sensors to a wide range of analytes in various sample formats, the response time between sample-to-answer results and their integration into cheap, rapid, efficient, portable, and commercially manufactured elements.